Medicine and Health Sciences Commons^™

The Distribution Of Cardiovascular Risk Factors And The Association With Cadre Amongst Healthcare Workers At A Tertiary University Hospital In Nairobi City, Kenya, Emma Andrea Khabure

Theses & Dissertations

Introduction: According to the World Health Organization (WHO), non-communicable diseases such as stroke, contribute to about 70% of the top ten causes of mortality in the world. The growing burden of Cardiovascular (CVD) risk factors has also been noted to affect the health workforce. According to the Ministry of Health in Kenya employing the WHO STEPS survey, 27% of Kenyans are either overweight or obese. Few studies have been done in Kenya to highlight the prevalence and impact of cardiovascular risk factors amongst healthcare workers. The variety of findings and paucity of data bring about the need to evaluate this …

Functional Status Among Patients With Established Copd Attending Tertiary Hospitals In Dar Es Salaam, Tanzania, Peter M. Tumbo

Theses & Dissertations

Background

Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable non communicable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases and influenced by host factors including abnormal lung development. It is associated with a lot of risk factors such as smoking, biomass fuel use for cooking and air pollutants in general.

Objectives

The primary objective of this research was to determine the functional status of patients with COPD. The secondary objectives were to determine the factors influencing …

Breast Cancer Molecular Subtype Classification According To Immunohistochemistry Markers And Its Association With Pathological Characteristics Among Women Attending Tertiary Hospitals In Tanzania., Allyzain Ismail

Theses & Dissertations

Background:

Breast cancer immunohistochemistry is a biological characteristic of the tumour which has a role to diagnose molecular subtype, prognosticate and guide treatment and categorised into 4 subtypes, Luminal A, Luminal B, Human Epidermal Growth Factor Receptor 2 (HER2) enriched and Triple Negative Breast Cancer (TNBC).

Objectives:

To determine the prevalence of each molecular subtype of breast cancer and determine their association with pathological and demographic characteristics.

Methods:

A retrospective cross-sectional study was carried out at two tertiary referral hospitals on participants who were recruited from the cancer registries from 2015-2022 and had a breast tissue biopsy confirming primary breast …

Experiences Of Diverse Health Care Workers’ Providing Maternal Care During The Covid-19 Pandemic: A Qualitative Study At Five Hospitals In Dar Es Salaam, Tanzania., Fatma Zahran

Theses & Dissertations

Background

There are drastic changes in patient care with respect to maternity due to the COVID-19 pandemic with negative impact to health care workers. With Interruption of everyday basic services, arose the need to redistribute the scanty health care workers across health care facilities in sub-Saharan Africa. Its effects and involvement on maternity practice in Sub-Saharan Africa are nevertheless to be analyzed. This study aims to explore the likely ramifications for obstetrics and gynecologic practice in Tanzania. At present there are limited studies looking at impacts of COVID-19 in sub-Saharan Africa and Tanzania. No study has been carried out to …

Barriers Of Iucd Uptake Among Sexually Active Nulliparous University Students In Dar Es Salaam Tanzania, Fatma Shaib Mohamed

Theses & Dissertations

Background

Family planning contributes an important role in prevention of unintended pregnancy, unsafe abortion, maternal and child mortality. One of the methods used is an IUCD that help in preventing unintended pregnancy. Un intended pregnancy is a public he alth concern worldwide among younger women, resulting into unsafe abortion. Preventing unintended pregnancies in youth is crucial yet challenging. Few studies have addressed the problem of the low utilization of IUCD among university students. This group is overwhelmed with physiological, social, and economic issues in relation to reproductive health especially on family planning accessibility and use. Gap of knowledge and skills …

Relationship Between Crown Like Structures And Body Mass Index In Breast Cancer, Sophie Wanjiru Irungu

Theses & Dissertations

Introduction: Breast cancer (BC) is the most common malignancy in women worldwide, including Kenya. Globally, increasing incidences of BC have paralleled those of obesity. The mechanism by which obesity contributes to BC is still an active area of research but white adipose tissue inflammation characterized by crown-like structures (CLS), which are macrophages surrounding dying adipocytes, is considered an important contributor.

Objectives: The primary objective was to determine the association between CLS and body mass index (BMI) in BC patients. The secondary objectives were to determine the association of CLS with BC risk factors specifically, age, menopausal status, subtypes of BC, …

Obstructive Sleep Apnea Syndrome Among Hypertensive Patients At A Tertiary Hospital In Kenya, Salim Abdallah Salim

Theses & Dissertations

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause a reduction or complete cessation of airflow. Warning signs of OSA include snoring, night sweats, and high blood pressure. However, there is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). This study purposed to elucidate the likelihood and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This prospective cross-sectional study occurred at the Aga Khan University Hospital in Nairobi, Kenya. A total of …

Quality Of Life And Sexual Function Of Women With Endometriosis At The Aga Khan University Hospital Nairobi, Edna Mohere Chacha

Theses & Dissertations

Introduction: Endometriosis is a benign, chronic condition that affects up to ten percent of women of childbearing age. It’s marked by the presence of endometrial tissue outside the uterine cavity (Giudice, 2010). It is a health condition with wide-ranging and pervasive sequelae making it a significant health concern requiring appropriate action (Rush & Misajon, 2018). We observed that there was a paucity of data relating to how endometriosis impacted on female sexual function and quality of life in sub-Saharan Africa, Kenya included.

Objectives: The primary goal of this empirical investigation was to determine the quality of life of women who …

Prevalence And Clinical Significance Of Unsuspected Intracranial Findings In Patients Undergoing Oncological Whole Body 18f- Fluorodeoxyglucose (Fdg) Pet Ct Imaging., Diana Kerubo Nyamieri

Theses & Dissertations

Background: 18F –fluoro-2-deoxyglucose (18F-FDG PET), an imaging modality that provides metabolic information of cancers, is integral in the diagnostic workup of many malignancies. Most oncological FDG PET scans are acquired from the base of the skull to the upper thighs, as lesions that take up FDG are usually within this field of view. Routine inclusion of brain within the field of view of all oncological 18FDG PET/CT studies leads to increase of both time of acquisition and radiation dose (albeit marginal) delivered by the CT component of the study, therefore one can debate if addition brain in oncological 18FDG PET-CT …

Placental Histopathological Changes In Covid-19 And Their Associated Effects On Adverse Pregnancy Outcomes, Eric Mugambi

Theses & Dissertations

Introduction: Coronavirus disease (COVID-19) is a significant cause of morbidity and mortality among pregnant women. Pregnant women infected with SARS-CoV-2 are at a greater risk of pre-eclampsia/eclampsia, non-iatrogenic preterm birth, stillbirth, and small for gestational age infants/fetal growth restriction (SGA/FGR), which share a common placental etiology. Placental histopathological changes attributed to COVID-19 have been demonstrated but there is a knowledge gap in how these changes impact pregnancy outcomes particularly those of placental origin.

Objectives: To investigate if there is an association between placental histopathology (maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), acute and chronic inflammatory pathology, and other findings …

Effect Of Aromatase Inhibitors On Bone Mineral Density In Black African Women With Breast Cancer, Dayib Said Buthul

Theses & Dissertations

Introduction: Aromatase inhibitors (AIs) are a commonly used type of endocrine therapy for post-menopausal women with breast cancer. In clinical trials with a predominant Caucasian population, it has been shown to cause reduction in bone mineral density of up to 1.5% and 3.2% in total hip and 2.6% and 4% in lumbar spine after 1 and 2 years of AI therapy respectively. Previous studies have shown that black women tend to have higher bone mineral density reserve compared to Caucasians. To the best of our knowledge no study has described the effect of AIs on bone mineral density in black …

Factors Associated With Non-Uptake Of Implantable Cardioverter-Defibrillator (Icd) Among Eligible Patients At A Tertiary Hospital In Kenya, Emmanuel Benge Aluoch

Theses & Dissertations

Background: Sudden Cardiac Death (SCD) is a major cause of mortality among patients with cardiovascular disease accounting for about 50% of deaths. Several studies have demonstrated the safety and efficacy of Implantable Cardioverter-Defibrillator (ICD) implantation in both primary and secondary prevention of SCD in at-risk populations. Despite well-publicized guidelines, ICD implantation rates remain low particularly in Africa with a paucity of data regarding factors associated with non-uptake and reasons for implant refusal. The study aimed to characterize these factors and identify reasons for ICD refusal. Understanding these factors and reasons for non-implantation will provide an opportunity to optimize ICD uptake …

Risk Factors And Outcomes Of Acute Kidney Injury Among Covid-19 Patients At A Tertiary Hospital In Kenya, Susan Cheruiyot

Theses & Dissertations

Background: Corona Virus Disease 2019 (COVID-19), a novel infection caused by the SARS-Cov-2 virus, was declared a global pandemic on March 11, 2020. Three years later, 350,000 Kenyans had gotten the infection, with approximately 5,700 reported related deaths. Despite emerging research on the new virus, studies from the African continent on the impact of COVID-19 on the kidneys have been few. Early studies suggest that up to 75% of patients with COVID-19 have a derangement in their kidney function as evidenced by new onset proteinuria and hematuria. That said, the prevalence of acute kidney injury has varied greatly across populations, …

Knowledge Attitudes And Priorities Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Clinic Administrators And Clinicians In Outpatient Medical Centres In Kenya: A Qualitative Study, Mary Wanjiru Kaniu

Theses & Dissertations

Introduction: Antimicrobial resistance is an important global health threat and it is estimated that by 2050 it will account for 10 million deaths globally. Low and middle income countries are disproportionately affected by the burden of antimicrobial resistance. One of the major causes of antimicrobial resistance is irrational and overuse of antibiotics. Understanding the knowledge, attitudes and priorities of healthcare workers and healthcare administrators on antimicrobial resistance and antimicrobial stewardship is pivotal in implementation of strategies to curb the spread of antimicrobial resistance.

Methods: A qualitative study using in-depth semi-structured interviews was conducted among clinicians and clinic administrators in …

Trends Of Intra-Facility Births Outcomes Before And During Covid-19 Era In Dar Es Salaam, Tanzania, Willbroad Kyejo

Theses & Dissertations

Background

While substantial progress had been made in reducing maternal deaths, there was a risk that the COVID-19 pandemic might have reversed the progress made in maternal and newborn health in the last two decades. As such, maternal and newborn outcomes had been a topic of interest during the pandemic.

Objectives

This study aimed to compare the number of childbirths as an indicator of maternal health service utilization and to assess maternal and newborn outcomes before COVID-19 (2011-2019) and during the COVID-19 pandemic (2020/2021) in 22 health facilities in Dar es Salaam.

Methodology

A retrospective cohort study was conducted at …

Factors Associated With Clinically Significant Hyperbilirubinemia Among Abo-Incompatible Newborns At A Tertiary Care Hospital In Kenya., Wandera Ivy Mwenesi

Theses & Dissertations

Background: ABO incompatibility is one of the most common causes of immune-mediated neonatal jaundice. It occurs in approximately 20-25% of all pregnancies. Literature shows that 60- 80% of newborns will develop physiological jaundice within the first week of life. Globally, the incidence ranges from 10-41%. Early detection of newborns with ABO incompatibility-related jaundice can prevent the incidence of bilirubin-induced neurological dysfunction. Whereas there have been extensive published data on rhesus isoimmunization, very few studies have examined ABO incompatibility and isoimmunization. From the published literature, there has been no known study that has assessed risk factors for developing clinically significant jaundice …